Cited 13 times in
Toward a Treatment Sequencing Strategy: A Systematic Review of Treatment Regimens in Advanced Gastric Cancer/Gastroesophageal Junction Adenocarcinoma
DC Field | Value | Language |
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dc.contributor.author | 라선영 | - |
dc.date.accessioned | 2022-05-09T16:47:42Z | - |
dc.date.available | 2022-05-09T16:47:42Z | - |
dc.date.issued | 2021-10 | - |
dc.identifier.issn | 1083-7159 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/188199 | - |
dc.description.abstract | Background: Platinum and fluoropyrimidine combinations typically comprise first-line (1L) therapy in advanced gastric cancer or gastroesophageal junction adenocarcinoma (G/GEA), although controversy exists regarding the use of 5doublet versus triplet cytotoxic regimens. Historically, second-line (2L) and third-line or later (3L+) therapy has been fragmented. Recent trials have increased the need for optimal treatment sequencing in advanced G/GEA. Materials and methods: We conducted a systematic search of peer-reviewed manuscripts of randomized clinical trials examining 1L, 2L, and 3L+ therapy for advanced G/GEA published from 2009 through November 19, 2019. When available, overall survival, progression-free survival, time to progression, overall response rate, and toxicity were extracted from each and compared descriptively. Results: In 1L therapy, chemotherapy triplets demonstrated variable efficacy improvements with invariable increased toxicity compared with platinum/fluoropyrimidine doublets. Currently, the only published report of positive outcomes using biologics in 1L describes adding trastuzumab in HER2-overexpressing advanced G/GEA. In 2L, doublet chemotherapy regimens are not uniformly more efficacious than single-agent taxanes or irinotecan, and ramucirumab has demonstrated improved outcomes both as monotherapy and in combination. Conclusion: For advanced G/GEA, review of trial results from 2009-2019 support 1L therapy with platinum and fluoropyrimidine and sequencing with taxanes or irinotecan in combination with biologics as effective 2L options. Escalating to a triplet may add some efficacy at the expense of added toxicity. Implications for practice: The rapidly changing treatment landscape for advanced gastric cancer includes increasing options for refractory disease. With multiple first-line platinum-based regimens, identification of those with the best benefit-to-risk ratio may provide guidance on treatment sequencing strategies. This article presents findings from the published literature of randomized controlled trials that included a first-line platinum/fluoropyrimidine combination and, for second-line trials, patients with platinum/fluoropyrimidine-refractory disease. This guiding summary could be a tool for clinicians to identify the optimal first-line regimen(s) followed by a strategy for subsequent regimens. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | AlphaMed Press | - |
dc.relation.isPartOf | ONCOLOGIST | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Adenocarcinoma* / drug therapy | - |
dc.subject.MESH | Antineoplastic Combined Chemotherapy Protocols / therapeutic use | - |
dc.subject.MESH | Esophageal Neoplasms* / drug therapy | - |
dc.subject.MESH | Esophagogastric Junction | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Stomach Neoplasms* / drug therapy | - |
dc.title | Toward a Treatment Sequencing Strategy: A Systematic Review of Treatment Regimens in Advanced Gastric Cancer/Gastroesophageal Junction Adenocarcinoma | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Daniel V Catenacci | - |
dc.contributor.googleauthor | Joseph Chao | - |
dc.contributor.googleauthor | Kei Muro | - |
dc.contributor.googleauthor | Salah Eddin Al-Batran | - |
dc.contributor.googleauthor | Samuel J Klempner | - |
dc.contributor.googleauthor | Zev A Wainberg | - |
dc.contributor.googleauthor | Manish A Shah | - |
dc.contributor.googleauthor | Sun Young Rha | - |
dc.contributor.googleauthor | Atsushi Ohtsu | - |
dc.contributor.googleauthor | Astra M Liepa | - |
dc.contributor.googleauthor | Holly Knoderer | - |
dc.contributor.googleauthor | Anindya Chatterjee | - |
dc.contributor.googleauthor | Eric Van Cutsem | - |
dc.identifier.doi | 10.1002/onco.13907 | - |
dc.contributor.localId | A01316 | - |
dc.relation.journalcode | J02415 | - |
dc.identifier.eissn | 1549-490X | - |
dc.identifier.pmid | 34288262 | - |
dc.subject.keyword | Gastroesophageal adenocarcinoma | - |
dc.subject.keyword | Randomized controlled trials | - |
dc.subject.keyword | Systemic therapy | - |
dc.subject.keyword | Treatment sequencing | - |
dc.contributor.alternativeName | Rha, Sun Young | - |
dc.contributor.affiliatedAuthor | 라선영 | - |
dc.citation.volume | 26 | - |
dc.citation.number | 10 | - |
dc.citation.startPage | e1704 | - |
dc.citation.endPage | e1729 | - |
dc.identifier.bibliographicCitation | ONCOLOGIST, Vol.26(10) : e1704-e1729, 2021-10 | - |
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